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论文编号：	12309
作者编号：	2120183067
上传时间：	2021/3/4 21:33:38
中文题目：	L医院基于资源耗用的相对价值量绩效管理方法应用研究
英文题目：	Application of performance management method based on RBRVS in L Hospital
指导老师：	黄福广
中文关键字：	资源耗用的相对价值量；公立医院；绩效管理
英文关键字：	RBRVS; Public Hospitals; Performance Management
中文摘要：	随着医疗体制改革的不断深入，药品、耗材的“零差价”使得公立医院无法继续通过药品耗材盈利，“以药养医”的时代已经结束，医生的收入因此有较大程度的下降，工作积极性受到很大打击，这直接影响到医院的业绩表现。在新医改不断强调医院公益性的情况下，公立医院普遍实行的以收支结余法为代表的绩效管理方法已经无法对医务人员产生激励作用，公立医院迫切需要找到一种新的绩效管理方法。一种即可以保证医院不损失公益属性、又可以提高医务人员工作积极性的绩效管理方法对公立医院同时实现社会效益和经济效益具有重大意义。 本文为探索公立医院绩效管理改革方向，采用研究绩效管理相关文献、比较和分析其他公立医院绩效管理案例的方法，以L医院为例对公立医院现行的绩效管理方法进行了分析，发现医院普遍采用的基于收支结余法的绩效管理方法存在导致医院逐利倾向、抑制医务人员提升技术积极性等问题，无法满足新医改要求，因此得出公立医院并不适合采用企业常用的绩效管理方法的结论。“基于资源耗用的相对价值量体系”（Resource-Based Relative Values Scale，RBRVS）是一种已经被发达国家范围内的医疗机构普遍采用的绩效管理方式。本文对RBRVS绩效管理方法的原理进行了研究，论证了相较于国内大部分公立医院采用的收支结余法，RBRVS从最开始的设计上就考虑到了通过提高支付给复杂诊疗项目的报酬来调动医务工作者主动提高技术水平的积极性，同时保持公益性，是一种符合新医改的要求、适合在国内公立医院推广的绩效管理办法。本文还根据L医院总体情况，对其引入RBRVS的必要性和可行性进行了论证。 根据对L医院引入RBRVS绩效管理方法实施效果的预测，本文认为RBRVS对公立医院改进绩效管理效率、提升综合管理水平、提高经济效益、激发医务人员工作和科研积极性等方面有实际帮助。本文还提示了国内其他公立医院在引入RBRVS时需要注意建立反馈沟通机制、结合诊断相关分组、单独考核专家型医生等问题，帮助其他医院可以更高效地开展绩效管理工作。
英文摘要：	Continuous deepening of medical system reform has made public hospitals unable to continue to make profits through drug and consumables, and the time of "relying on drugs to support doctors" has ended. As a result, the income of doctors has been greatly reduced and their working enthusiasm has been greatly affected, which directly affects the performance of hospitals. Under the requirement of public welfare of hospitals, the way of performance management represented by the balance of income and expenditure commonly implemented in public hospitals has been unable to stimulate medical staff. Therefore, public hospitals urgently need to find a new performance management method. A performance management method that can not only ensure that the hospital does not lose the public welfare attribute, but also can improve the enthusiasm of doctors and nurses is very significant for public hospitals to achieve social and economic benefits together. In order to explore the direction of performance management reform in public hospitals, through the study of performance management related literature, analysis and comparison of other public hospital cases, and takes L Hospital as an example to analyze the current performance management methods in public hospitals. It is found that the performance management method based on the balance of revenue and expenditure method commonly used in hospitals has some problems, such as making hospitals profit-making and restraining the enthusiasm of medical staff to improve technology, It can not meet the requirements of the new health care reform, so it is concluded that the performance management methods commonly used by enterprises are not suitable for public hospitals. Resource based relative values scale (RBRVS) is a performance management method widely adopted by medical institutions in developed countries. This paper studies the principle of RBRVS performance management method, and demonstrates that compared with the income and expenditure balance method adopted by most public hospitals in China, RBRVS can improve the enthusiasm of doctors and nurses within the public welfare of public hospitals. It is a performance management method that meets the requirements of the new health care reform and is suitable for promotion in domestic public hospitals The necessity and feasibility of introducing RBRVS into L Hospital were demonstrated. According to the prediction of the implementation effect of RBRVS in L Hospital, this paper believes that RBRVS will help to improve the efficiency of performance management, level of comprehensive management, economic benefits and stimulate the enthusiasm of doctors and nurse. This paper also suggests that the introduction of RBRVS in domestic public hospitals should pay attention to the establishment of feedback communication mechanism, the combination of diagnosis related groups, and independent assessment of expert doctors, so as to help other hospitals to carry out performance management work more efficiently.
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